The Keto Rash is very real for some new keto dieters. Good news though – you can get through it, and we have some suggestions to help!!

Sometimes when some people dive into the waters of ketogenesis, they start to itch. Itching like crazy.

But it’s a different kind of itch – one that sometimes burns… is sometimes sporadic… and sometimes only happens when sweating! We refer to this as “keto rash”.

Hopefully it’s obvious that PricePlow is highly intrigued by ketogenic diet research. Even with all of that love, we KNOW there are a few things to watch out for. We already crushed keto breath through simple interventions like tongue scrapers. However, there remains one more thing to watch out for on keto diets…. prurigo pigmentosa. It’s perhaps better known as the keto rash!

In this guide, we’ll teach you a few easy ways to stomp this problem to let you continue your high-fat adventures more comfortably.

Please note we avoid recommending prescription irritation creams and antibiotics in this article. If the problem gets that bad, please go to your general care physician or dermatologist for such advice – or discontinue the keto diet immediately. We stick to the low hanging fruit here that is well within your reach. As always, NONE of this is medical advice.

Why might this problem occur?

Given that the keto diet is a niche field, it is unlikely that much research funding would be granted to help solve this rare issue. However, at a precursory glance, the problem seems obvious to us – especially when you can smell it! It comes down to the biochemistry of ketones.

This little bugger is a big part of the problem.

As discussed previously in our article on keto breath, acetone is produced by the body during ketogenesis. By now, you should know acetone isn’t just a natural substance — it is most well-known for its use as nail polish remover!

Ketones are hydrophilic in nature. To understand what that means, all we have to do is break down the word into its consistent parts. “Hydro” refers to water while -philic means “loving.” Ketones love water. Ketones can DISSOLVE in water.[1]

This is what allows ketones to travel through the blood in the first place — as blood is 92% water![2] So we got nail polish remover flying through our blood at about half a mile an hour. So what? Well, as mammals, we also sweat. We sweat a lot.

The interesting thing about keto rash is that it often occurs in high-sweat areas! So it’s often postulated that the rash is likely due to acetone irritating the skin when you sweat. Basically, you’re excreting a fractional portion of nail polish remover through your pores… and it isn’t so pleasant on the nerves nor the nose.

What is the problem?

While there are many theories out there explaining “why” of the rash, it is more important to understand what the actual issue is. The keto rash refers to a phenomenon in some individuals a day or two after they enter ketosis. Once their body is in full-keto producing mode, they’ll itch. They won’t stop itching… and when they work out or are in hot weather, it gets even worse. It gets pretty bad…

Okay, maybe it’s not scratch-your-skin-off bad, but it’s still an annoying issue to deal with. Interestingly enough, it seems to go away a day after users consume carbohydrates again. If we lean on our theory that acetone itself causes the issue, this makes a lot of sense. The body produces less acetone (and ketones in general) when there’s sugar in the blood to deal with, so you wind up with less acetone, and thus less irritation. The rash goes away.

Fixing the Problem

There are a few DOZEN solutions to this problem that have been suggested across the internet. As we’re a very practically minded team of supplement experts, we’ll only cover the options that will absolutely help you crush your itch!

Realize that it’s probably temporary

First off, before you go crazy, realize that it’s likely a temporary issue. The good thing about ketosis is that your body eventually finds homeostasis with the amount of ketones it has circulating, and over time, urine tests show that acetone goes down in favor of beta hydroxybutyrate, another ketone produced when in ketosis.

So, consider some of the lower-cost solutions out there, but “sucking it up” and staying clean may be all you need for a week or two.

Finally, that Gold Bond Extra Strength Medicated Powder (the green can) has a new use (for you guys who know what we’re talking about). This is a good way to dry the skin and relieve the sweating. The medicated version provides a mentholated tingle that feels and smells good.

Tea Tree Oil is often a great way to wash irritated skin (again, see your dermatologist for any serious conditions), and when training, The Body Shop Tea Tree Cleansing Wipes are very good to have around, at least for your worst areas.

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Be Smart With Clothing

Definitely the lowest hanging fruit, in our opinion. If you’re wearing four layers and you live in Florida… you’re almost ASKING for it. Strive for complete comfort. Always wear appropriate attire for your climate. If you’re in a hot place, consider wearing fewer layers.

Keep Your Room Cold At Night

These wipes have worked very well for us when needed. Not cheap per wipe, but thankfully we didn’t even need a full pack before getting through the keto rash.

An extension of the previous option. If you’re covered in sweat when you wake up, it might be time to make your room nice and cool when you switch into temporary hibernation. Given that night sweats impact between ten to sixty percent of older patients, this might be just the fix.[3] Consider killing your heat-unit at night to save money AND stop the itching!

Shower more! And try this tea tree oil soap:

Yeah, we’re calling you out on this one. How often are you finding yourself passing out in bed after a night-time gym session? You’re too tired to hop in the shower. You slam down a protein shake and pass out, covered in the sweat from the session. We’ve all been there. If you suffer from keto rash, it might be worth putting in that extra bit of effort. Showering will help wick off the sweat and stop the acetone from messing with your skin.

Bone Broth

Keto Rash or not, everyone should have a bottle of this stuff (FungaSoap) in the house for when ‘things’ happen!

Broth is an intervention that we recommend frequently here, especially the electrolyte content. But why for the keto rash? Well, bone broth is rich in both glycine and proline, which can help reduce inflammation throughout the body. Considering that the keto rash is possibly due to irritation or skin inflammation, throwing in some foods that MIGHT help reduce inflammation is wise.[4,5]

Fish Oil

On that same wavelength, Omega-3 fatty acids have been shown to reduce inflammation when consumed in adequate amounts. On keto, it might be a good move to throw in some salmon every week to make sure you’re getting in enough of these valuable fats. If you can’t stomach fish itself, take liquid fish oil at least. It’ll help you fight off some irritation [6].

Consider Ditching The Keto World

As always, our nuclear option. The last resort. If the keto rash doesn’t clear up with any of our interventions, and you can’t wait it out (or sweat it out), consider ditching the diet and trying something else.

While we love the keto diet, it just doesn’t work with some people. The first thing you should focus on is your overall health. Your skin is the largest organ on your body. Constantly damaging it by scraping at itchy spots might not be the best move for OVERALL health.

Conclusion

The keto rash is probably the most annoying and hard to address keto symptom out there. While keto flu is easily fixed by electrolyte corrections and other simple interventions, the rash is much harder to fix. Overtime, we’ll update this article with better interventions. Thankfully, the keto rash is a rare symptom. Most people that try out this diet will never get the itch.

Mike Roberto is a research scientist and water sports athlete who founded PricePlow. He is a biohacker with extensive experience in supplementation and dietary modification, whose personal expertise stems from several "n=1" experiments done on himself while sharing lab tests.

Mike's goal is to bridge the gap between nutritional research scientists and non-academics who seek to better their health in a system that has catastrophically failed the public.